吲哚菁绿联合亚甲蓝在乳腺癌前哨淋巴结活检中的临床应用

目的:探讨吲哚菁绿(indocyanine green,ICG)联合亚甲蓝在乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)中的临床应用价值。方法:共入组39例乳腺癌患者,在光学分子影像手术导航系统(surgical navigation system,SNS)的引导下,使用ICG联合亚甲蓝实施SLNB。快速冰冻病理证实前哨淋巴结(sentinel lymph node,SLN)转移者,即刻行腋窝淋巴结清扫(axillary lymph node dissection,ALND);SLN阴性者免于ALND。结果:联合法实施SLNB检出率95%,成功检出SLN125个,平均检出3.2个SLN,准确率95.0%,灵敏度100%,假阴性率0%;蓝染法检出率87.2%,成功检出SLN71个,平均检出1.8个SLN,准确率89.7%,灵敏度93.7%,假阴性率为6.3%;统计结果采用x2检验,检验结果具有统计学意义。结论:ICG联合亚甲蓝实施乳腺癌SLNB成功率高,假阴性率低,临床效果不亚于亚甲蓝,是实施SLNB的新方法。

Application of Indocyanine Green Combined with Methylene Blue Dyes in Sentinel Lymph Node Biopsy for Patients with Breast Cancer

Objective:To test the feasibility of combination use of indocyanine green (ICG) and methylene blue dyes for sentinel lymph node biopsy (SLNB) in breast cancer.Methods:39 breast cancer patients were enrolled in this experiment guided by our surgical navigation system(SNS) to detect sentinel lymph node(SLN) with the combination method. If the intraoperative pathology results of SLN were negative, axillary lymph node dissection (ALND) was avoided.Results:Using the combination method, 95%of SLNs were identified, 125 SLNs were dissected with the average of 3.2 and the accurate rate was 95.0% with the sensitivity of 100% and false negative rate of 0%. For the aspect of methylene blue method, the detection rate was 87.2%. 71 SLNs were dissected with the average of 1.8 and the accurate rate was 89.7%with the sensitivity of 93.7%and false negative rate of 6.3%. x2 test was used in our statistical results and the test results were statistically significant.Conclusion:ICG combined with methylene blue method have higher detection rate and lower false negative rate, which can be as a new method for SLNB.